Men, Relapse, and the Practice of Vulnerability

During the COVID-19 pandemic, stress and isolation have been paramount, and that has driven many people in recovery to relapse. We recently wrote about relapse in women, but men also have their unique set of challenges.

Along these lines, many men have found themselves in unprecedented circumstances this past year. For example, a male patient recently shared with me how devastating he found the transition to quarantining. Not only was he suddenly stuck at home full-time, but also his college and high school-aged children were attending classes remotely. He previously helped coach their lacrosse games, which were also shut down.

In one fell swoop, so many elements that he depended on to give his life structure and purpose were gone. Additionally, his parents had health issues and he could not visit. Suddenly, he found himself in tremendous emotional pain, and he saw his children and parents suffering as well.

This was compounded by the fact that all his usual outlets for handling stress were no longer available. There was literally nowhere he could go to find relief, even in his own house. He was struggling to support everybody else, and all the while he was not caring for himself, which ultimately led to his relapse.

Just as it did with this male patient, the overwhelming nature of the pandemic pulled the rug out from many others. And for those men who are used to being a rock for everyone around them, finding themselves in such situations can be emotionally debilitating. Although vulnerability – and admitting you need help – is the very key to recovery, expressing it can feel terrifying to many men as they try to remain strong for everyone else in a crisis.

Men struggle with the practice of vulnerability

Vulnerability can be uncomfortable for men. In a culture that often teaches men that showing emotion is a sign of weakness and that they must prize self-reliance, it takes practice to say, “I need help,” and then, even more importantly, to actively receive that help. So, to then be faced with a disease like addiction, where they must admit that they cannot manage everything on their own, is very difficult. We are asking them to share feelings and experiences they may not even realize they’re carrying. For a man, who is not used to intimacy, that can be scary.

However, the practice of vulnerability is one of the most powerful skills a man can build. It is a tool that supports recovery and minimizes the potential for relapse. The practice of vulnerability helps establish the emotional flexibility needed to cope with stress in a productive way.

The role of lingering childhood trauma

So much of relapse in men ties back to emotional difficulties, including unresolved issues from early life. Traumatic childhood experiences can stem from emotional, physical, psychological, or sexual abuse or grief over the loss of a parent or loved one. Children experience trauma in different ways, and it’s not unusual for adults to have these childhood experiences triggered during stressful times. They also sometimes foster the core beliefs: I'm not worthy. I'm not good enough. I'm not lovable. Understanding these foundational experiences and negative core beliefs and then working through them with a behavioral specialist are key to re-engaging after a relapse and recommitting to recovery.

Many times, men will also struggle from growing up in a household where the impact of substance use or mental health issues were profound but not addressed. In fact, they may have learned not to talk or share what was going on and instead found ways to escape painful feelings, which can lead to unhealthy coping behavior.

I'm a firm believer in the idea that it is easier to intervene earlier on in the relapse process – which includes unhealthy behaviors that start to take over before a man even picks up a drink or drug again. That said, building a bridge back to recovery comes down to several areas. These include thorough assessment, patient-centric individual and group therapy, family support and therapy and an individualized aftercare plan.

It has been a devastating year. We want to convey to men who are struggling that they are not alone. It’s not unusual for men who were in long-term recovery to relapse during this time. The first step is asking for help, because we all need support to get through these unprecedented times. On the flip side, we also encourage families to get help and learn strategies for taking care of themselves.